Doctor with MoneyWith the 2015 Medicare Physician Fee Schedule(MPFS), CMS began a dialogue about how the growing trend toward hospital acquisition of physician offices and subsequent treatment of those locations as off-campus provider-based outpatient departments was impacting Medicare reimbursement and overall Medicare spending.

MedPACIn the first of two reports for 2015, the Medicare Payment Advisory Commission (MedPAC) issued its report on the state of Medicare reimbursement and enrollment.

CMSEffective March 18, 2015, CMS made changes to their Provider Enrollment policies and incorporated them into Chapter 15 of the Program Integrity Manual.

Change AheadChanges for Beneficiaries

Medicare Advantage

United States CongressIn a vote late Tuesday evening the Senate voted 92-8 to kill the Medicare Sustainable Growth Rate (SGR) formula ending an almost 18 year headache for physicians and Congress. The bill will now go to President Obama. Obama has already expressed his support for the bill and is expected to sign it into law.

surveyWEDI recently updated its survey on ICD-10 preparation on the part of providers, software and service vendors and payors. The results point to some progress has been made especially on the part of payors but that there is still a sluggish response on the part of many vendors and providers perhaps lulled into a potentially false hope of another delay.

CAQHIn March, CAQH launched CAQH ProView™ as part of an effort to modernize systems and an attempt  to “streamline credentialing, improve network provider directories, speed claims adjudication, and simplify administrative processes for providers and health plans.”   You can visit

ICD-10 RedThere’s been a lot of buzz in the press recently about the upcoming ICD-10 deadline. Will it happen? Will Congress create another delay? For some insight on the situation, we reach out to eMDs for their perspective.

CMSIn 2013, in an effort to clarify Medicare medical necessity policy around hospital inpatient admissions, CMS issued a policy specifying that an admission will qualify for Part A reimbursement when a physician certifies that a patient’s treatment is expected to require an inpatient stay spanning two midnights.

Doctor with MoneyIn our last blog post, we began a deeper dive into the MACRA legislation - the legislation recently passed by the House to fix the Sustainable Growth Rate (SGR) system that creates such uncertainty in physician reimbursement every year.